Think Twice About Friending Your Nurse on Social Media

Beware of the possible privacy pitfalls of befriending your nurse on social media.

BY ELAINE S. DEMEYER, M.S.N., RN, AOCN

PUBLISHED February 20, 2018

People who have cancer spend a lot of time with their medical team members, especially nurses, during long and frequent hours of treatment. It is only natural to develop relationships with some of them. Some of these relationships might cross the line between patient/provider and friend, and some may last long after treatment ends. Connecting on social media seems like an easy way to keep in touch with staff that cared for you during a tough time in your life.

Social media has become pervasive in our culture. Posts, tweets, videos — that is how many people now communicate with one another. Social media refers to any web-based or mobile technology, such as Facebook, YouTube, Snapchat, Instagram, Vimeo, LinkedIn, Twitter and CaringBridge. But beware — some pitfalls could bring negative consequences for both you and your nurse.

Use of social media can easily violate patient confidentiality. The National Council of State Boards of Nursing social media guidelines state that “it is imperative not to mention patients by name or provide any information or details that could possibly identify them in order to protect patients’ right to privacy.” Nurses have a legal and ethical responsibility to maintain patient privacy and confidentiality.

Disclosure is often unintentional. Posts are not private. Someone can simply take a screenshot of the information and send it on or upload it to another place on the internet. Posts never truly disappear. Even if a post is deleted, it may still live somewhere on a server and could be discovered in a court of law. To protect the privacy of your own information, as well as your friendly nurse’s nursing license, consider the downstream effects.

WHAT IF… you post that you had a great weekend with family visiting but are now feeling really tired? Your nurse might read that and wonder if the fatigue is from overactivity or related to anemia or even a sign of recurrence. Is the nurse legally obligated to report seeing something concerning about your health? What if a post reveals a behavior that could pose a health risk — for example, a picture of you drinking wine, and the nurse knows you are on medication that should not be taken with alcohol. Nurses have professional, legal and ethical responsibilities to consider. Now that they have this piece of information, what do they do with it?

WHAT IF… you come back to your place of treatment to celebrate your cancerversary and it becomes a photo op? One nurse takes a picture with you and posts it with the caption “This is why I became a nurse.” You may not want everyone to know about this cancer journey. You have a right to decide what is shared and with whom.

WHAT IF… your nurse friend posts something revealing about your condition? It could have an effect on your future employment. There is not supposed to be discrimination in the workplace for survivors, but in reality, it does occur. If a nurse posts a picture of you on a social media account, it might show up in an employment search about you many years later. If you are concerned about this, you should state clearly that you do not want photos of you with your nurses or care team posted on social media.

The scenarios above could result in a Health Insurance Portability and Accountability Act of 1996 violation and disciplinary action by the board of nursing, as well as the nurse’s employer. Most organizations have guidelines about taking photos of any person who works at their facility or received any services there. A written formal consent is usually required, and it needs to be obtained from everyone in the photo. Another patient in the background or a characteristic — say, a tattooed arm — that could be even remotely linked to another patient could create a messy legal situation.

So, how do you avoid potential boundary crossings on social media? Err on the side of caution. Don’t put your nurse friends in the position of endangering their careers. For your benefit, as well as theirs, it is best to avoid interacting with them on social media.